Individual provider Active NPI

Tanya Helen Fetters, FNP-C

  • Family Nurse Practitioner
  • Chandler, AZ
National Provider Identifier
1407572159
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
171208 Issued in AZ
Practice address
1915 E Chandler Blvd Ste 1
Chandler, AZ 85225-5117
Phone
(480) 653-9792
NPI assigned
Oct 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 171208 AZ Primary

Addresses

Primary practice location

1915 E Chandler Blvd Ste 1
Chandler, AZ 85225-5117

Mailing address

1915 E Chandler Blvd Ste 1
Chandler, AZ 85225-5117
Phone (480) 653-9792

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230705002249 AZ Practitioner - Nurse Practitioner 2567821879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Medical Associates PLLCGroup PAC ID 0547575474, 4 clinicians

Practice addresses (Care Compare)

1915 E Chandler Blvd
Suite 1
Chandler, AZ 85225-5117
Phone (408) 306-5151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
171208AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Medical Associates, PLLC CurrentSince May 24, 2023 Accepting new patients

Locations

1915 E Chandler Blvd
Ste 1
Chandler, AZ 85225
Phone (408) 306-5151

20928 N John Wayne Pkwy
Ste C4
Maricopa, AZ 85139
Phone (480) 306-5151

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1665705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1407572159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 E CHANDLER BLVD STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852255117",
            "telephone_number": "480-653-9792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 E CHANDLER BLVD STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852255117",
            "telephone_number": "480-653-9792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETTERS",
        "first_name": "TANYA",
        "middle_name": "HELEN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-14",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "171208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.